Choosing an Assisted Living Facility

The assisted living horror stories are out there. Stories about elderly ladies walking out into the baking heat and later found dead of exposure, about poorly-trained staff not knowing what to do in a serious emergency, and about violations of the dignity of assisted living residents. While not all assisted living facilities pose such risks, it is crucial for anyone considering the options for an aging parent to ask questions and to not let a friendly handshake or a long impressive list of services fool them into making the wrong choice.

Keep in mind that any facility you are considering means that you are essentialy interviewing, not one, but an entire group of potential employees to whom you will be entrusting the care of your aging parent. Doesn't it make sense, if only from a financial standpoint, to ask the same questions a prospective employer would ask? Add to that the delicate layer of "what's best for Mom or Dad," and it becomes imperative to ask the tough but necessary questions.

The best rule to follow is this: if a question occurs to you, ask it. There are no wrong questions here, and there is no such thing as being too inquisitive. Get everything in writing, and don't be afraid to ask for a facility's annual report along with any violations it has been cited for. This is public information and is available through your state's Ombudsman's office.

If possible, try to talk with others who have placed family members there. Talk to neighbors of the facility and to anyone who might know someone who either lived or worked there. An unfortunate factor associated with choosing long-term care facilities is that you often don't know how bad they are until you've placed a parent there. In this case, you can either move your parent elsewhere or be extra vigilant of the care they are receiving, if only to keep both management and staff on their toes. Visit often and stay as long as you can, and take note of anything you see that doesn't seem quite right, especially of some of the more visible aspects of services, such as the purchase of cheap generic foods or residents sitting in front of a television set all day. These could all be indications that your loved one may not be getting the care you're paying for.

Don't assume that the "well-trained staff" is all that. In the case of professional nursing personnel, ask for credentials, certifications, work history and check with your state's nursing board for any reports of poor performance or complaints. Once your parent has moved in, notice signs of understaffing and resident-to-staff ratios. If certain things aren't getting done, that sometimes means inadequate staffing. Again, check your state's regulations, which can sometimes be shockingly lax particularly when a facility accepts a high rate of residents with special needs or needs that go beyond what the staff can reasonably manage without cutting back on other residents' care.

Another critical issue to consider when choosing a care facility is whether or not it offers Aging in Place. What this means is that the resident lives there for his or her remaining years, a choice that eliminates the need to move to a nursing home at at time when such a move would be stressful. In an article published by Hilltop Assisted Living in Bath, Maine, and displayed on its website, it is recommended that "Consumers interested in aging-in-place services should look closely at residents when touring facilities and ask direct questions about the levels of care available in the facility."

The bottom line: there is no such thing as a bad question when considering the care and comfort of an aging parent, spouse or other family member. Don't be fooled by the building's architectural grandeur or swayed by management's gushing testimonials. While in some cases, decisions to relocate an aging parent must be made quickly and without much preparation, be as thorough as possible in your research and the interview process if time is on your side. It's not unheard of for small private facilities to be more profit-oriented than care-oriented. Knowing this beforehand can go a long way toward making one of life's most difficult decisions a bit easier.

Today's Caregiver: Assisted Living Communities Checklist
http://www.caregiver.com/channels/ltc/articles/assisted_living.htm

News: Aging in Place
http://www.hillhouseassistedliving.com/news/news_main.html

Problems With Staffing, Training Can Cost Lives
http://www.usatoday.com/money/industries/health/2004-05-26-assisted-day2_x.htm